CaRMS – The Canadian Resident Matching Service has released a comprehensive report on Canadians studying medicine outside Canada. And the findings are not good, particularly for foreign trained physicians who are facing tough competition — at home and abroad.

The study estimates that there are approximately 3,500 Canadian students enrolled in medical schools abroad, all sharing a desire to return home to Canada to practice medicine. This figure reflects an almost 100% increase since 2006 when CaRMS published its last study. At that time, approximately 500 students were thought to be studying medicine abroad.

This could make it even more difficult for IMDs (international medical doctors) to get a coveted residency position in Canada. As yet, there is still no distinction made between IMDs and IMGs (international medical grads) when it comes to the CARMS application process. There are 7,500 IMDs registered in Ontario alone.

It’s expected that the new foreign medical grads will account for an additional 700 applicants. That’s about one-third of the total number of Canadians studying medicine in Canadian schools.

Some of the key findings of the study:

• Students are spread around the globe and are enrolled in 80 different medical schools, in 30 countries. The most popular locations for Canadians are Ireland, Australia, and the Caribbean.
• Twenty-one percent of the students are children of Canadian physicians who did not get accepted into a medical school in Canada. They have a higher median age, are older (73% are 26 to 30 years of age), and have more education than medical students studying in Canada. The largest number of students come from Ontario and British Columbia.
• The cost of studying outside Canada is more than double the cost of studying at home. The median debt for a medical student studying abroad is $160,000 (CAD) compared to $71,000 (CAD) for a Canadian medical student.
• * Graduates of medical schools in Australia and Ireland were more successful than grads from the Caribbean in arranging Canadian clerk ships, clinical rotations, and post-graduate training opportunities in Canada.
• Ninety percent of respondents expressed frustration over the perceived barriers to getting medical residencies in Canada once their studies were over. Caribbean students were the most frustrated.
• While Canada’s biggest doctor shortage is in family medicine, only 21 percent of the students who responded to the survey indicated that they would pursue a career in the field. And since many of them intend to be specialists most likely in urban settings, it does little to solve the doctor shortage in Canada.

Many of the stats release by CaRMS are backed-up by anecdotal evidence in an article written by Josh Dehaas for Maclean’s Magazine entitled “Want degree, will travel: Getting into into med school abroad may be easier, but it’s tough to come back”.

The option for many IMGs — as it is with IMDs — is to apply for a residency in the United States. As Ah Yin Eng, the head of the Association of International Physicians of Canada and a veteran GP in Pembroke, Ont., says in the article: “Governments complain of a medical brain drain but with IMGs, year after year, we lose them to the States.”

So while the Ontario Government brags about creating more spaces for foreign trained physicians, this new report will be a sobering reminder that medicine is a tough dream to follow — especially in Canada.

CaRMS is a not-for-profit organization that works in close cooperation with the medical education community, medical schools and residents/students, to provide an electronic application service and a computer match for entry into postgraduate medical training throughout Canada. The survey was distributed to 32 international medical schools with 1,082 students responding.

The study can be downloaded from the CaRMS Website.